Nurses are traditionally the backbone of patient care. They form the largest percentage of the health care workforce, far outstripping physicians. But are nurses leaders as well as doers?

In a recent survey of the NEJM Catalyst Insights Council – comprising clinicians, clinical leaders, and health care executives – nearly three-quarters of respondents say nurse leaders should be considered the equal of physician leaders in care delivery. “I think organizations are now realizing leadership training and leadership positions for nurses are [very critical] investments to the success of their foundation, which is patient care,” says Susan Robel, RN, BSN, MHA, NEA-BC, CPXP, Executive Vice President, Chief Nursing Officer, and Chief Patient Experience Officer at Geisinger. Yet there is work to be done to fill the pipeline of nurse leaders, from the patient floor to the C-suite, according to the survey. Nearly two thirds of respondents (63%) estimate that less than a quarter of the leadership roles in their organizations are filled by nurses.

Stephen Swensen, MD, MMM, FACR, Professor Emeritus, Mayo Clinic College of Medicine, Senior Fellow, Institute for Healthcare Improvement, and Theme Leader for NEJM Catalyst’s Leadership theme, says if the lack of representation of nurses among the leadership ranks is not corrected, it will have a negative impact on an organization’s ability to transform care delivery. The survey finds that disinterest in leadership roles runs high, with more than half of respondents (58%) estimating that fewer than a quarter of nurses are interested in leadership roles. “You’ve got these nurses who spend these years training, love what they do, and don’t want to move beyond it,” Swensen says, adding that organizations should entice nurses to leave the bedside and take on leadership roles.